Therapeutic Alliance between Psychologists and Perpetrators of Intimate Partner Violence: A Feminist Ethics of Care Interpretation

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Therapeutic Alliance between Psychologists and

Perpetrators of Intimate Partner Violence: A Feminist Ethics

of Care Interpretation

Renata Guimarães Naso

ISNR: LIU-TEMA G/GSIC2-A – 17/004-SE

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Linköping University

Department of Thematic Studies The Unit of Gender Studies

Master Programme: Gender Studies Intersectionality and Change

Title: Therapeutic Alliance between Psychologists and Perpetrators of Intimate Partner Violence: A Feminist Ethics of Care Interpretation

Author: Renata Guimarães Naso

Supervisor: Redi Koobak

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Acknowledgements

I would like to dedicate this thesis to my mother, father, and brother who inspire me every day to seek knowledge, be true to myself and fight for transformative changes.

I am immensely grateful to Redi Koobak for the guidance and care towards this process.

Also, I would like to thank the participants of this thesis for sharing with me aspects of their work and life. Without them, this dissertation would not be possible.

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Abstract

This thesis investigates the construction of the therapist-client alliance in the therapeutic setting with perpetrators of intimate partner violence (IPV). Moreover, it explores the ways a Feminist Ethics of Care perspective could enhance the partnership between the actors. To fulfil such aims, the author conducted six in-depth semi-structured interviews with psychologists working at one of the most renowned institutions for perpetrators of IPV in Norway and Sweden. The analysis of the psychologists' discourses demonstrates that several factors are influential in the alliance construction. The most important aspects are: the clients' perspective towards the psychologists; the therapists' views towards the clients; the psychologists' engagement with moral sentiments; the power struggle between the actors; and the use of techniques for the professionals to enhance their connection with the clients. Besides that, the discourses also show that moral superiority seems to guide the psychologists when relating with the perpetrators. Their views are embedded in an individualistic ethics based on the principles of Kohlberg's Ethics of Justice. The thesis suggests that a collective ethics such as Gilligan's Feminist Ethics of Care would enhance the partnership between the actors. This theoretical framework allows the psychologists to change their superior moral views of the clients to a moral responsibility towards them. When such movement in perspective happens, the therapists begin to see the perpetrators as human beings with many different facets. Consequently, they truly deny a judgmental impression towards their identity.

Key words: intimate partner violence, perpetrators, therapeutic alliance, morality, feminist

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Introduction

In the late 1980s, the insights of the Norwegian criminologist Kristin Skjørten drastically changed the field of intimate partner violence (IPV), especially concerning the therapeutic scenario in Europe. Until then, women’s shelters, feminist movements and family/child protection governmental agencies in the Nordic countries engaged with treatment centres to assist survivors of IPV. It was through Skjørten’s revolutionary idea that the focus eventually changed from IPV survivors to perpetrators. The proposition to provide therapeutic treatment to male perpetrators generated an indispensable inter/national debate.1

The World Health Organization (2006) defines IPV as any harmful physical, sexual and psychological action(s) that occurs between intimate partners in a relationship. This relationship can be either heterosexual or homosexual, even though the latter remains in need of research (COAG, 2015). Many scholars consider the violent act between intimate partners as a result of the unequal patriarchal/gender system individuals are embedded. Consequently, they link IPV to dominant notions of masculinity (Pina et al., 2009). When society values rationality over emotions more, men are pressured to deny their vulnerabilities and demonstrate their power over women. The indulgence of violence will continue if individuals do not recognize an embodied notion of self (Enander, 2011).

Men are mostly reported to be the perpetrators of IPV in heterosexual relationships, but there is a clear evidence of female perpetrators in heterosexual relationships, and both genders in homosexual relationships (WHO, 2006). This gender symmetry is a disputed issue among researchers of violence against women and family violence. Even though there are similar figures of women and men performing violent acts, researchers point out to the importance of also considering the nature of the acts, its context and the structure of the relationship between the actors involved. By doing this, it is clear that the type and degree of physical violence differs significantly, with men committing more severe violent acts than women (Graham-Kevan, 2007).

Skjørten and their2 _{colleagues saw in the inclusion of male perpetrators to the}

therapeutic setting as an opportunity to engage with IPV from a different perspective. Even though the Duluth Model3 _{(Pence and Paymar, 1993) was already widespread in the United}

1 _{Reference note: the participants of this dissertation provided the information regarding Skjørten and}

the institution in question.

2 _{Throughout the entire dissertation, I have tried as most as possible to use gender-neutral pronouns}

since I want to distance myself on making assumptions about the individual’s gender identity. However, I think it is relevant to identify the participants of this research according to the gender identity they provided me.

3 _{It is uncertain how much influence the US context had on Skjørten, but this doesn’t diminish the}

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States of America among interventions for male batterers, it appears that the basis for Skjørten's support can be found in Norwegian criminology, particularly, in its strong belief in alternative, rehabilitative solutions to social issues, not only relying on criminal justice. Prison and conviction are also part of the process, but this specific criminology trusts intervention in a complex social issue with therapeutic treatment.

The revolutionary aspect appears in the possibility to redefine the moral norms surrounding criminality and punishment. Skjørten and their colleagues surprised the society and sparked a discussion on the unclear barriers of morality. Traditionally, individuals pursuing improper moral choices are judged by the society as evil characters who deserve a form of punishment based on retaliation. They become forgotten societal members differentiated from those with a superior morality. Engaging with the morally wrong in the therapeutic level would transformatively change the rigid notions of deviance. It would allow an empathic and holistic understanding of perpetrators, without forgetting the responsibility they have towards the violent act. Moreover, the form of punishment would change, by societal members recognizing their responsibility towards the ones committing violence.

Giving male perpetrators the opportunity for behavioural and mind-set change through therapy was an idea that was hard to swallow. Several politicians, members of the health care system and social services boycotted Skjørten’s idea by implying that they – and the other professionals involved in the project – were building a morally degrading partnership with the offenders. The critics were questioning the founders’ will towards eradicating violence against women. They believed in the traditional punishment of male perpetrators by only incarcerating them. In their logic, male perpetrators should by no means receive assistance on regenerating their behaviour. They considered it morally absurd that the perpetrators should be treated on equal terms with the survivors since they were the ones causing harm.

Even though there was a definite resistance established, the Norwegian women’s movement – in constant dialogue with Skjørten’s team – understood their intentions and the importance of bringing male perpetrators to the clinical setting. Such a movement, along with the women shelters in the country, had a significant influence on state policy and other social agencies. This allowed Skjørten’s project to continue and eventually transform it into a treatment centre. It then became one of the most renowned institutions providing therapeutic treatment for IPV perpetrators in Norway – and later on in Sweden.

The historiography of the institution demonstrates the importance of Skjørten’s resistance to the societal models that were provided for individuals involved with IPV. It created the possibility to produce knowledge in the field of IPV and, consequently, the engagement with other bodies of thought. The therapeutic relationship between psychologists working at

for perpetrators as well as the Duluth model on the next subsection regarding previous literature on the field.

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the institution and their clients is particularly useful for understanding more about Skjørten’s intentions when proposing their idea.

Previous Literature

In 2003, the World Health Organization (WHO) published a report to cover all the existent interventions for male perpetrators around WHO’s acting countries (Rothman et al., 2003). Such document demonstrated the type of interference – therapeutic, social and political – and the central institutions conducting it. It showed that the United States was the pioneer in providing treatment for male batterers after IPV was officially considered a crime in the country – in the 1970s (McLaughlin, 2017). The Duluth model (Pence and Paymar, 1993), which I

previously mentioned above, is a programme created among several others. Feminists, women shelters and the criminal justice partnered for the creation of the Duluth Model as a social-therapeutic intervention for male batterers. The program joins aspects of gender and societal norms along with the personal background of the male perpetrator (Barner and Carney, 2011). In Europe, programmes for male perpetrators emerged in the late 1990s, with Skjørten’s institution being the third organisation created, after others in Germany and Austria. Scholars have been focusing on treatment approaches in order to understand its efficacy, find solutions for improvement and to contribute to the reduction of IPV in society (Stuart, 2005). However, there is a lack of research on the precise therapeutic alliance between therapists and perpetrators. Moreover, literature is scarce regarding the professional’s ethical considerations when providing therapy for this group of clients (Abrar et al., 2000).

Lambert and Barley (2007) reflect on the therapist-client relationship by reaffirming that a positive relation between actors increases the success of therapy and consequently, the chance of client’s behavioural/mindset change. According to the authors, to acquire such relationship a series of factors need to be ensured, such as the reflection towards the particular positions of psychologist and client. Empathy appears as a potential contribution to sustaining a beneficial interaction between the actors.

Recently, McLaughlin (2017) published an article in which they inquired the considerations regarding IPV at the American Psychological Association Ethics Code (APA). Their study does not deeply investigate how psychologists are ethically inclined towards their clients (perpetrators). Rather, it resumes the possible ethical challenges that clinicians might have when working with these clients. Also, it examines how the APA can guide psychologists to have a better ethical relation with perpetrators.

McLaughlin’s (2017) contributions are important for my thesis since it reassures the importance of therapists to acquire knowledge towards IPV and be prepared for a complex ethical relation to their clients. It points out the difficulty for some professionals to balance their own moral considerations with their clients. Besides, the author reflects on the meanings of an

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ethical justice when therapists let their personal views of their clients influence on the process. The principle of justice that appears at the APA reminds professionals that all individuals are entitled to seek treatment and benefit from it. The negative image that the therapists might have towards people that conduct harm can be an obstacle for engaging with such principle.

The study mentioned above (McLaughlin, 2017) specifically contributes to my understanding of the ethical considerations that psychologists might have towards perpetrators. Unfortunately, the author does not touch upon the particular contributions of theoretical frameworks based on ethics – such as a Feminist Ethics of Care perspective – can bring to the therapist-client alliance. Tong (1997) comes closest to this issue when analyzing care and empathy on the ethical relation of doctors and patients. The scholar shows the clinicians’ dilemma towards subjectivity and objectivity regarding their involvement with patients. Tong (1997) defends that there should be a balance between becoming non/personal, since both emotions and rationality are part of moral considerations. Their paper reflects on the gender lens attributed to care and empathy as belonging to women. The terrain of oppression and discrimination towards women is illustrated in the traditional discipline of medicine, that considers that care and empathy, as women’s characteristics, are inferior moral attitudes.

Tong’s (1997) considerations were very helpful for my understanding of how ethical considerations of care and justice relate to the particular doctor-patient bond, which is embedded in a context of male dominance. It also encouraged me to redefine the negative image that care has towards masculine-grounded disciplines such as Psychology, by observing the contribution that a caring, ethical perspective can bring to the therapeutic setting. Carol Gilligan's (1982) Feminist Ethics of Care focuses on the construction of care as an ethics of resistance, in which women’s morality are valued and applied.

Aims and Positionality

I find the connection between morality and ethics that Skjørten’s insight brings fascinating. It revisits the responsibility of treatment centres and psychologists to social issues through a reflection on moral and ethical boundaries. Therefore, I was quite surprised to find a lack of research illustrating the involvement of Feminist Ethics of Care in the therapeutic relation between psychologists and perpetrators of IPV. The work of Carol Gilligan (1982) provides a relational understanding of self and other that is essential for the psychologist- perpetrator dynamic. Not only does it challenge the traditional understanding of justice, but it also allows for a humanistic psychological perception of those considered morally wrong.

In this sense, I had the idea to conduct this research with the aim of calling attention to possible transformative changes in the therapeutic relation between psychologists and perpetrators of IPV, taking into consideration contributions from Feminist Ethics of Care

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perspective. To do this, I needed to investigate the way in which this particular group of therapists perceive their clients and construct their relationship. Therefore, in this dissertation, I examine the discourses of six psychologists – one woman and five men – working at the institution created by Skjørten and their team4_{. These professionals work in offices of the}

institution both in Norway and Sweden.

It is not my intention to carry a comparative analysis between Norway and Sweden when analysing the discourses of the research participants. I focus on the meanings that they generate collectively. I am not particularly interested in these countries’ contexts since I am mostly interested in the institution per se and the environment in which the institution was created. Thus, the choice of the institution – due to its expertise – and the lack of research towards the European context when investigating ethical perspectives and therapy for perpetrators were the reasons that I chose such contexts. Moreover, my choice was also based due to my positionality both in Sweden and Norway.

As mentioned above, I am interested in examining the power relation between the client and the psychologist, from the perception of the latter. The reason for this is not only a scientific curiosity due to a lack of research on the psychologists’ opinions towards this group of clients; but also due to my positionality as a trained psychologist, and a woman who has experienced violence. My perceptions towards perpetrators were constructed through my experiences in Brazil – the place I was born and grew up in – and different countries around the world, where I have lived and experienced what it means to be in the position of a white woman.

In Sweden, India, Brazil, and Iceland I was unfortunate to experience acts of violence from both complete strangers and members of the community I was part of. These included variations of small harassments, inappropriate touches, verbal and psychological abuses, daily stares, sexual invitations and so on. My body was perceived as an object. I tried to hide my features or to change my clothes. But my appearance was not the problem. The problem was my status as a woman, particularly a woman from a country where women are seen as sexual deviants. However, similarly, local women experienced daily forms of harassment, even worse depending on their race, sexuality, and class. Even though my experience of violence was not within my family, IPV has knocked on my door during small talks with friends, therapy sessions with clients and public events.

As a trained Jungian psychologist, I was taught to act as a mirror in front of the clients. I had to be a tool for the clients that helped them to see themselves and ponder if change was desired and needed. By allowing my experiences of harassment to interfere with my pre- judgment, I am unable to act as a mirror. Moreover, rather than seeing the client as human, I would only be able to view them as deviant. For me as a psychologist and a gender studies

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scholar, it is necessary that I am aware of this bias. Though I am mindful of the fact that my positionality will always influence the therapeutic setting, I do not want to have the resistance towards the clients’ narratives on account of my personal experience.

Research Questions and Outline

To conduct my inquiry and touch upon all the issues mentioned above, I will explore the following research questions.

§ How do psychologists working with perpetrators of IPV in the therapeutic setting construct the client-therapist alliance?

§ What could a Feminist Ethics of Care perspective contribute to this client-therapist alliance?

I have structured this dissertation in four different parts. Section one refers to the theoretical framework of Feminist Ethics of Care. In section two I will present the material, together with the institutional context and participants/clients details. Section three consists of the dissertation’s approach, with its methodology, methods, and ethics. Section four is the analysis, where I present the influential factors for the construction of the client-therapist alliance. Also, I explore my second research question. In the conclusion of this work, in section five, I will come back to the dissertation’s aim, summarize its findings, indicate its limitations and suggest future research topics.

I would like to conclude this section by contemplating on the form of writing of this thesis. My two-year Master Programme in Gender Studies taught me invaluable lessons for living a life with more attention to my surroundings. The act of challenging my rigid thoughts and moving away from my comfort zone – that propelled this thesis – were aspects that I have learned during the programme. Here, I am taking the challenge of not only dialoguing between two bodies of thought – Gender Studies and Moral Psychology – but also engaging with a mix of creative and academic writing.

Creativity as a form of writing encourages my mind and body to dialogue, and, together, develop a fluid cohesion that gives me the motivation to produce knowledge differently. It is a way to challenge the academic status quo and to evoke a pluralism of ideas (Lykke, 2014). After all, this pluralism brings the acceptance that is so important in this thesis; it is the first step in creating relational societies where care and justice go hand in hand.

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Section One

Feminist Ethics of Care

Preface

One of the perks of living in a society relates to the demand of becoming a moral being. Morality has been questioned and constructed by philosophers, psychologists, and members of the religious communities, among others. It consists of judging material aspects and individuals' actions and thoughts into values of right and wrong. But what constitutes that which is morally good or bad? The systems of values that we allocate to our behaviour/thinking determine an action in/proper. Moral systems might contribute to the construction of an egalitarian social structure. At the same time, it can reinforce judgmental perceptions towards individuals. Then, who makes such decisions? Who structures the values that people nurture when relating to one another? All the answers will depend on the investigation of morality, which means, on the ethics that takes places (Wienpahl, 1948).

Ethics are the practices that regulate and define morality, which implies problematizing moral behaviour and thinking (Yuval-Davis, 2011). Each profession and body of thought conceptualizes ethics differently according to the prevalent type of relation between the actors involved. In the case of this dissertation, it is the ethical relation between the psychologist and the perpetrator of IPV that interests me. This interaction is a unique alliance between two actors with different power positions. Social, political and personal considerations influence their role in relation to one another. The morally questionable attitude of someone that inflicts harm can be too demanding to be accepted depending on the professionals’ moral discourses. The problematization of morality and the construction of an ethical relation can either be a motivation or an obstacle for an empathic understanding.

In this section, I take into account the considerations of Moral Psychology, especially the discussion involving feminist ethics of care and ethics of justice (Gilligan, 1982; Kohlberg, 1969). I believe that the meanings brought by feminist care ethicists contribute to an integrative understanding of what it means to have an ethical relation in the particular therapeutic setting that I investigate. This happens because the meanings of empathy, relationality, trust, power, compassion, responsibility, and justice that emerge from this context are of great significance when analysing the psychologists’ perceptions towards their clients. Feminist ethics of care reminds us that a proper conduct involves much more than an abstract notion of justice. It argues for a moral development where self and other morally constitute one another through their attachment (Gilligan, 1977). To start, I will briefly explain the context in which feminist ethics of care emerged.

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Ethics of Justice

Her life was endangered. All the memories we had made together were going to disappear. I could no longer sit there and watch her facing this disease. Suffering and despair became our ghosts. We were winning some battles, but it did not matter anymore. The cancer was going to win the war. Suddenly, I heard about a new medicine that could save us, mainly, save her. Our lack of means was a huge obstacle of acquiring such miraculous drops. But there was this man. I was going to appeal to the humanity of this pharmacist. He could help us; he could give us the medicine. He will be touched when hearing about our love story and her personality. How could he not be? Well, he was not. Telling him about the beauty of the woman that was going to depart this world and leave behind so many loving souls did not matter. Asking for money from a friend or promising the pharmacist to pay the rest later did not matter. Not even questioning his compassion and tenderness towards human life made any difference. I did not have any choice. I took it. I stole it. It was for everyone’s sake. I had to do it (Kohlberg, 1969).5

This and other moral dilemmas constituted the study of Lawrence Kohlberg (1969) when analysing the meanings of human morality. Based on Piaget's considerations towards Development Psychology, Kohlberg (1969) became the key figure in discussions of the stages of moral development in connection with cognitive aspects of the individual. They presented moral dilemmas, such as the one described above, to white North American men in the 1960s. Was it right to steal from the pharmacist to save his wife life? Was it wrong to cross the limits of another human being? How to establish values of right and wrong? Through the participants’ discourses, Kohlberg elaborated on a theory of moral development based on six main stages. This theory would culminate in Gilligan’s reflection towards a non-individualistic ethics. It would lead to the emergence of the Feminist Ethics of Care.

Kohlberg (1969) perceived morality as a move from an egocentric perspective of self to a universal principle of justice. At first, individuals see their own needs as absolute and more important than those of the society where they are embedded. Then, they move from a personal to a social perspective, which represents a transition to the ultimate performance of universal rights and duties based on fairness. Thus, individualistic notions of social justice define the meanings of right and wrong, which are considered universal to all humans (Medina- Vicent, 2016). However, through universalism, Kohlberg ignores the intersection with social categories such as gender, race and sexuality. As a consequence, the author reinforces the moral philosophical tradition of considering the human through a male perception (Gilligan, 1977; 1982).

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The main result of Kohlberg’s (1969) study demonstrates the differences between men and women as moral beings. Women are unable to reach the most advanced stage of moral development because of their position in the private sphere of intimacy and care. Such position ties women to a relational mode of being with the other.

I found Gilligan’s (1977) observations on the paradoxical nature of Kohlberg’s statement particularly illuminating. The author points out that the basis of what it means to be a woman, regarding conduction of affective relationships where emotions and connection are central, is the one that harms their acquisition of a more appropriate morality. Thus, women’s judgment will always be deficient under the eyes of Kohlberg due to their nature and how they relate to others. This unequal normative perspective not only places women as hierarchically inferior to men but also opens space for the latter to silence women due to their considered lack of judgment (Gilligan, 1982).

Ethics of Care

Gilligan’s book In a Different Voice was the founding work in the movement toward a Feminist Ethics of Care perspective. The author enters the conversation precisely to question the oppressive male perception that Kohlberg – among other ethicists – have universalised uncritically. Gilligan’s (1982) critique expresses the problematic nature of considering one perspective of moral development as a universal framework for all. The theoretical model created by Kohlberg (1969) not only reinforces the women’s moral conduct as improper but also contributes to positioning them as both secondary and less relevant. Women become beings that one cannot trust in judgment. Their concern with the other through a relational perspective troubles their capacity of making decisions and, consequently, diminishes them to infants who have still a lot to learn in respect to morality (Gilligan, 1977).

Therefore, for Gilligan, the biggest problem of Kohlberg’s theoretical considerations arises from the relationship between autonomy and rational obedience towards justice. To connect the individuals’ agency with principles of justice without taking into account their positionality in relation to the surrounding is to ignore the interdependence between people (Nordhaug and Nortvedt, 2011). Gilligan’s critique opens space for the valorisation of an interactional ethics. This means that the author urges the understanding of humans in relation with one another and with the particularities of each, which are embedded in the social, political and psychological context. Universalism is substituted with people’s positionality and their connection with others when making moral decisions. This symbolizes ethics and morality as dialogical constructs between self and other, where affection, intimacy and attachment cannot be ignored (Gilligan, 1977).

The so-called women’s morality – which is a term that will be discussed further on by Tronto (1993) – became possible through Gilligan’s study on the relation between women and

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abortion. Their research data included discourses of women engaging with the complex decision of aborting their pregnancy. Through the analysis of such speeches, Gilligan understood that responsibility is an issue of extreme importance when going through such moral dilemma. The responsibility aspect does not only refer to the possible future newborn (other), but also the potential future mother (self). These women were concerned with solving the moral dilemma without hurting oneself and the other (Gilligan, 1977).

At first, their internal desire not to have a child prevailed, but then, as the moral reflections developed, they could not ignore their own obligations and duties towards the other. This does not necessarily imply that they did not conduct the abortion, rather that the sense of responsibility of self and other is present in the development of their moral thinking and actions. This means that they were taking into consideration such responsibility when deciding the best conduct towards the matter (Gilligan, 1977).

I find it important here to take a moment to reflect on the particular choice of participants in Gilligan’s (1982) study. The interviewees were women dealing with a specific dilemma that involved their own sexuality. Moreover, they were potential mothers. It is through the control over their body that women can move from a space of dependence to a place of self- empowered judgement where judgment occurs towards their own methods. Their sense of responsibility emerges from their perception of a non-isolated self, but in relation to the possible child.

By choosing this particular population, Gilligan is problematizing the meanings of morality, but also the patriarchal principles that allocate women only to the private sphere. The mother-child relation that is symbolized through Gilligan’s choice promotes a dialogue on the meanings of motherhood, womanhood and humanism. It is a feminist perspective that calls for the acceptance of considering more than rights and duties, but the choice of moral decisions through the consideration of both self and other (Gilligan, 1977).

Hence, through Gilligan’s considerations, pluralism is possible. The author argues for the consideration of another view towards moral boundaries and decisions. The scholar’s most important conclusion is that the moral inferiority of women is implausible. Their societal position and role do not make them morally less capable; rather it gives them a different voice. She affirms “the ideal of care is an activity of relationships, of seeing and responding to need, taking care of the world by sustaining the web of connections so that no one is left alone” (Gilligan, 1982:73). By doing this Gilligan ensures that an affective and relational meaning of care is valued as much as an individualistic sense of justice on ethical considerations (Gilligan, 1977). In summary, Feminist Ethics of Care argues for the attentiveness and empathy to the vulnerable, the sense of responsibility of self/other and the nurturance of a relationship where intimacy and trust are at the core (Gilligan, 1977).

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Political Theory of Care

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Joan Tronto is another feminist care ethicist who has brought meaningful considerations to the discussion of ethics of care and justice. Following from Gilligan's work (1982) and the body of thought created by the Scottish ethicists Hume, Smith and Hutcheson, Tronto (1993) deeply merges the considerations about ethics of care and ethics of justice presented above. The scholar emphasises that care is necessary for justice to occur.

Moreover, Tronto brings the meanings of care to the political and social level of power structures. One of the biggest critiques that Tronto (1993) has towards Gilligan’s work is the lack of involvement with the political body. Gilligan (1977) highlights the importance of making moral judgments based on care and responsibility but does not necessarily reflect on how such ethical dialogue might occur within institutions. Tronto (1993) reinforces the values of care in the political context by determining how political and social discourses contribute to the assistance towards human need. Morality in Tronto’s perspective is both seen in the interpersonal perspective of a mother-child relationship and in the political arenas that provide the meanings for motherhood.

Tronto (1993) reminds us to see care as practices that assist individuals to connect with each other and give a helping hand to one another in times of need. Responsibility, attentiveness, empathy, trust, interdependence, intimacy and power are care values that individuals should nourish for the establishment of a “just, pluralistic and democratic society” (Tronto, 1993: 162).

Phases of Care

Caring about, taking care of, care giving and care receiving are critical phases that

describe the ethical relationship between self and other (Tronto, 1993). I will explain these meanings taking into consideration the ethical relation explored in this thesis, that is the relation between a psychologist and a perpetrator of IPV.

When the client enters the office, the psychologist asks them to explain the reasons for seeking therapeutic treatment. In the case of IPV, the consequences of a violent act are the main reason for requesting assistance. In listening to the story of the client, attentiveness is the first value of care to appear. It is through the recognition of the vulnerable other and the needs of this other that the psychologist is going to be able to care about their client. This recognition appears when the professional listens to the client’s discourse with empathic ears (Tronto, 1993).

The action of care designates the phase taking care of. After listening to the objectives of the client and developing a perspective on what the aims of the therapy should be, the

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psychologist reflects on the necessary steps to be taken during the therapeutic process. The sense of responsibility appears here when the psychologist assumes responsibility as a professional towards that individual who needs care. This feeling of responsibility helps the professional to ensure methods for ending suffering and harm both to the client and to others situated in the client’s surroundings. At the same time, the client needs to trust the competence of the professional, to believe that their behaviour and mind-set will change (Tronto, 1993).

Care giving correlates intrinsically with taking care of because it corresponds to actively

carrying out the activities that were planned in the latter. Here, the psychologist needs to reflect on their role as a therapist and consequently, on the ways their advantageous power position will influence the therapeutic relation. Compassionate authority is an important idea to account for so that one is not trapped in a morally superior position of power (Tronto, 1993).

Care receiving corresponds to the alliance between the psychologist and the client. The

interaction between them will depend on a series of factors. The success of the therapy will only be achievable if cooperation between the therapist and the client is possible. Issues of power on both sides will influence this interaction that needs to be taken with tolerance, sympathy and compassion between both actors. Trust appears here again since for the cooperation to be conceivable mutual trust needs to exist. The psychologist will demand a series of measures on the part of the care receiver to ensure this mutual trust and the cooperation between both. For example, this includes taking responsibility for the acts of violence committed (Tronto, 1993).

For the treatment to be viable and for social justice to be served – through the end of violence – ethics of care with all its meanings needs to settle. By observing the ways ethics of care takes place in the therapeutic/ethical relation between the psychologist and the perpetrator, I am arguing for the need to create a dialogue between values and practices of care. The next sub-section explores such values. Empathy is vital for this dialogue since it is through an empathic understanding of self and other that connection is indeed feasible (Slote, 2007).

Values of Care

Empathy

Here, I take the definition of empathy as the ability to move from one’s own position to the position of the other. This movement involves the capacity for understanding the perceptions and emotions of the other, with tolerance and compassion (Mercer and Reynolds, 2002). Reading previous literature on empathy, I could not help noticing that it was regarded as an attitude. I contend that this is a problematic way of understanding it. As Bondi (2007)

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explains, if we pursue empathy as a trait, we are rejecting the possibility of developing empathy as a process and, consequently, its volatile nature.

Therefore, empathy should be considered a process of ‘becoming’ (Deleuze and Guattari, 1987) that always evolves through the acquirement of new characteristics and intersections with different emotions (Mercer and Reynolds, 2002). In the therapeutic setting, for example, the relationship between therapist and client will generate a set of positive, neutral and negative emotions that will contribute to – or hinder – an empathic understanding of the other’s point of view (Cuff et al., 2014).

The process of becoming empathic involves a series of factors. Masto (2015) points out that an empathic understanding occurs not only when one individual absorbs sentiments from the other. The presence of cognitive ability for identifying the meaning(s) of such emotions is also necessary. Otherwise, the person would only feel an emotional contagion and would not be able to characterize the perspective of the other. Thus, cognitive and affective empathy need to merge in a constant partnership during the empathic process.7

Slote (2007) highlights this aspect by stating that without both the dialogue between mind and body – emotion and cognition – empathy cannot be established. Slote’s (2007) deliberation sees empathy as the ‘glue’ that joins the ethics of care and justice. The author demonstrates that a deeper and truthful understanding of the other will only happen when morality takes into consideration individuals as embodied selves and sustain the connection among them. For Slote (2007), an empathic understanding is a way of acquiring such integrative morality.

Moreover, Slote (2007) defends an empathic, caring ethics, in which empathy is grounded on a care relationship. In their book The Ethics of Care and Empathy, they discuss the role of empathy in the morality of care, by affirming that moral education is possible through the comprehensive account of empathy. Through the engagement with several feminist care ethicists, Slote (2007) concludes that when a relationship involves care, it signifies as morally acceptable. Consequently, an empathic concern develops. Thus, by provoking harm to an intimate partner, the client in question conducts a morally ‘wrong’ attitude. The perpetrator did not care for the well-being of the other and did not exhibit empathy towards the other desires, emotions and thoughts (Slote, 2007).

In the case of the therapeutic alliance between the psychologist and the perpetrator, empathy involves respect towards the client’s point of view and positionality, which means a rational/emotional understanding of the client’s experiences, thoughts, feelings and conflicts (Tronto, 1993). An ethics of empathic care, as Slote (2007) advocates, signifies a relationship

7 _{In this thesis, I am trying to escape from the Descartian dualism of emotion and reason. Both}

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of trust, cooperation, compassion and responsibility. The nurturance of this alliance is necessary for both actors, but mostly the psychologist. The professional will take the first step in demonstrating concern and care for the client’s suffering and at the same time will make an effort to mirror the positionality of the latter. A cooperative alliance between the therapist and the client creates a space where moral development can happen. Thus, this increases the success of the therapeutic process on ending the present violence (Elliot et al., 2011).

Compassion and Sympathy

Two feelings that interconnect with empathy and most of the times receive the same definition as the former are compassion and sympathy. Compassion is when the psychologist discerns their client suffering and are considerate about it. At first glance, compassion and empathy do not differ, since the first can also be constitutive of an empathic process. However, by looking attentively, empathy is better defined as the process of sharing feelings with someone, no matter the morality of those feelings. Compassion is directed to the suffering of the other and generates the emotional state of sorrow for the other, due to the experiences that the individual is facing (Beaumont et al., 2016). Compassion does not have an inferior status to empathy, and it is considered an act of care. Consequently, compassion is an important feminist ethics of care value.

As seen above, through Gilligan’s (1977) considerations, the sense of responsibility does not apply only to the other, but also to the self. The need to engage in a relation of care to oneself allows the psychologist to be able to conduct their best as a professional and, consequently, increases the therapeutic bond and the success of therapy. Self-care is intrinsically correlated with compassion and empathy since it signifies a look of tolerance towards the limitations and possibilities of one’s positionality (Slote, 2007).

Now, sympathy must enter the conversation. Hein and Singer see this affective state as the capacity for “feeling for the other”, both negative and positive emotions (2008, 157). Such moral sentiment differentiates from empathy, since the latter means “feeling as the other” (Hein and Singer, 2008, 157). In the therapeutic setting, the client can describe a harmful situation that they suffered as a child, which would make the therapist recognize this emotion and feel it, characterizing an empathic understanding. In being concerned with the client due to their suffering, but not indeed feeling the same pain, the therapist is acting sympathetically towards the client. Again, both are acts of care and values from a feminist ethics of care perspective (Slote, 2007).8

8 _{Empathy, compassion and sympathy are considered moral sentiments since they are capable to}

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Trust, Responsibility and Power

As mentioned before, responsibility towards self and other in feminist ethics of care is seen through the paradigm of relationality. Individuals are embedded in relations with others, and it is through the eyes of the other that moral regulation happens. Thus, responsibility to comprehend such interdependence is essential. In the therapeutic context, the psychologist recognizes the vulnerabilities of the client and establishes an ethical relation by having an empathic understanding. After the recognition, the professional has a moral responsibility of engaging with this suffering if they truly care about the client’s well-being and the ones involved (Tronto, 1993).

At the same time, the client engages in a relation of trust towards the psychologist. This trust is embedded in the certainty that the therapist, as a caregiver, will do their best to take care of the client. The construction of this trust will depend on a number of factors, among them, the institution where the therapist acts and the knowledge of IPV. From the psychologist’s perspective, the trust posted on the client refers to the acceptance of the treatment and the recognition of conducting a violent act (Sevenhuijsen, 2003).

Therefore, trust involves cooperation from both actors. The client openly needs to share all the behaviours, thoughts and emotions that are part of the violent act that was committed. This openness can be extremely difficult due to the infliction of harm that is morally unacceptable. At the same time, the psychologist needs to be open to listening empathically to a content that might cause moral disgust. Moreover, it involves a recognition from both parties that therapy is embedded in relationality and interdependence. In this sense, becoming dependent on one another is only possible when both parts can count on each other.

Sevenhuijsen (2003) mentions the danger of labelling specific roles for therapist and client, even though their different positions lead to such classification. Understanding the care relation is problematizing the notion between rescuer and victim. As just seen before, both psychologist and client have a responsibility towards each other, the success of therapy and, in this case, the end of the violence. Indeed, their responsibility has different weights since the client is the one conducting the violent act. By holding more knowledge and being distant from the problem, the psychologist holds the power position over the client. The professional has no right to be considered the ‘rescuer’ because they hold an advantageous position, since the therapeutic process is of cooperation and interdependence, and the psychologist also has vulnerabilities.

Hence, it does not give permission to actually abuse their power over the client. The non-paternalistic process of care allows the therapist to act without control and imposition of their own believes. It implies an understanding of the client’s discourse. Since harm is constituent of this discourse, the moral development will be the priority of the psychologist. Sentiments that positively empower the client to conduct well will accompany such

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development. Consequently, the psychologist acts with authority based on growth and care (Jones, 1993).

Relational Autonomy

Autonomy has traditionally been linked to an individualist notion of self. Self- governance, self-sufficiency and self-reliance are the main characteristics that an individual must have to be autonomous, according to a liberal morality based on rationality and justice. Feminist care ethicists argue for an autonomy based on care values such as interdependence and relationality. Their argument goes hand in hand with all the concerns of this section – the notion that self and other are in constant dialogue with each other and shape the construction of both identities and moral judgments. Consequently, ‘relational autonomy’ has been created as a term to highlight the respect and recognition for someone’s social-political surroundings (Christman, 2014).

Alongside autonomy, there is the notion of paternalism, which was briefly mentioned above. A paternalistic attitude limits individual’s autonomy since it takes into consideration that the latter is not capable of conducting moral judgments. The psychologist, for example, when imposing on their client a particular method of work or only one possible moral behaviour is going against the client’s will. This imposition shows a lack of understanding of the individual as a master of their own (Christman, 2014).

Paternalistic attitudes in an ethical relation have several levels, varying from the total eradication of autonomy to a soft interference. Often times, the professional can affirm that the client is not able to make decisions of their own, since they are governed through sentiments of harm and violence towards another. In this case, they mildly interfere with the autonomy of the client, since they believe that as soon as the client acquires knowledge, one will make better decisions. A strong paternalism, on the other hand, is characterized by the situation in which the psychologist does not think that the subject lacks knowledge or understanding, but even so continues to impose what one believes is morally right. In this case, the moral opinions of the psychologist are controlling because of the belief that the client will not develop knowledge that is necessary for behavioural change (Christman, 2014).

Relational autonomy calls for an ethics where the professional engages dialogically in the process of developing the client’s moral behaviours, and this leads to better decision- making. Through the reflection on the client’s feeling and attitudes towards others, the psychologist can show the importance of compassion and empathy towards another position. Moreover, the attachment between them will possibly demonstrate a relation of trust and care in which the client might not be used to but can replicate one’s own intimate partner. Relational autonomy allows the cooperation between therapist and client to grow, to eradicate

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paternalism – weak or strong – and advance the client's perceptions towards what it means to conduct morally acceptable actions (Christman, 2014).

Final Considerations

In this section, I outlined the main concepts in a Feminist Ethics of Care. Gilligan (1982) argues for the problematization of the individualistic and universalizing view of Kolhberg’s theory of moral development. Through the relationship between mother and child, Gilligan demonstrates that the self interacts with the other interdependently and responsibly. They remind us that we cannot consider only moral acts as that which is right or wrong for the self since we have responsibility towards the other.

Tronto (1993) enhances the argument by affirming that this other is not only personal but also political. This social-political view means that the relationship between self and other is inserted in a context. The political and social actors at play are also interdependent with the self, at a different level. At the same time, Slote (2007) adds that empathy is the key sentiment for a relation of care to actually take place. It is towards empathic understandings of the other and the community that the self will be able to have moral attitudes of care. Trust, compassion, sympathy, power and relational autonomy appear as care values of the connection between self and other.

In this section, my aim was to advocate for the understanding that an empathic and caring relation is only possible when both actors relate to each other in an interdependent level. Besides, through the work exhibited here, I argue for a plural morality where right and wrong are seen through the concern for the vulnerabilities of the self, the other, and the context in which both are inserted. The theoretical framework presented will serve as a basis for the investigation of the psychologists’ perception.

After this theoretical exposition, I am now in a good place to analyse the psychologist- client relation through a feminist ethics of care perspective. In particular, I am interested in the question whether this alliance is based on an ethics where care and justice have similar importance.

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Section Two

Context

Overview

As seen in the last section, discourses and perceptions of self and other are always inserted into a particular socio-political context. In this dissertation, the history of the studied institution and the transmission of its ideas contributes to the work conducted by the psychologists. Consequently, the way such work is led, and the fundamental principles behind it, influences the construction of the therapist-client relation.

In this section, I will present the empirical material of this dissertation. I will first return to the history of the institution that was briefly mentioned in the Introduction. Then I will introduce the participants of this thesis: six psychologists working in Sweden and Norway, and coming from different career backgrounds. Finally, I will briefly introduce the characteristics of the clients (perpetrators of IPV) that attend the therapeutic treatment.

The aim of presenting this group of perpetrators is to describe the therapeutic scenario vividly. However, the focus in this section is not the psychologists’ perceptions of their clients, but to outline the characteristics of the latter according to gender, age, nationality, class, education and sexuality.

Institution

9

Foundation

As previously mentioned, during the 1980s, the Norwegian criminologist Kristin Skjørten had an idea that would revolutionize the field of IPV in the therapeutic setting. They held all the experience of working with women survivors in Norwegian crisis centres, to suggest that men who commit violence should receive therapeutic treatment. By that time, the Norwegian women's movement was quite influential among the state and society as a whole. Initially, the project received state funding for three years that could be later renewed. However, even though the team of psychologists and the Norwegian criminologist had strong support from the women’s shelters and Norwegian feminists, in the first year, the project suffered an intense backlash. This reaction happened because of its controversial nature. The healthcare system and social services affirmed that the project served as an alibi for male perpetrators to continue committing violence.

9 _{The participants of this research – psychologists working with perpetrators of IPV – provided the}

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The stable dialogue between the women’s movement, women shelters and members of the project enhanced the comprehension of the importance and the type of work that was being conducted. It was thanks to their influence that the survival of the project was possible. Over the years, the project grew and turned into one of the most renowned institutions in Europe.

Today, the institution receives funding from the government, though there is a lack of municipal grants in a few of the Norwegian offices. This financial absence remains an obstacle for the institution because it limits its ability to offer treatment to some individuals. Without public funding, the treatment would cost 300 Norwegian Krones per hour. Also, there is no possibility for a refund of this amount from the healthcare system.

In 1997, the psychologists working at this institution studied female perpetrators of IPV. They inquired into the differences between men and women when committing violent acts. From this initial study, an internal project offering therapeutic treatment for female perpetrators started. The Norwegian law that obliged women to have the same opportunities as men made the institution’s internal project a permanent matter.

Hence, today, the eleven offices of the institution, spread across Norway, provide individual/group therapeutic treatment to both male and female perpetrators and violence towards their children. Intimate partner violence intertwines with this type of violence.

In Sweden, the National Strategies indicate the necessity of working with IPV, since this is a significant health problem in the country10_{. Nevertheless, psychologists faced more}

difficulties when trying to establish a treatment centre for perpetrators in the country than their colleagues in Norway. The dialogue between the women's movement, women's shelters and the team of professionals willing to offer treatment was challenging because they did not agree on core principles. There is still a particular resistance from the healthcare system and the social services for applying the methodology established in the national strategies.

Even though there were obstacles and a public controversy, the professionals launched a community project in 2010, focusing on therapy for male perpetrators. They started without partnering with the aforementioned Norwegian institution. It was only after two years when they changed their gender focus by accepting female perpetrators as well that the Swedish branch run the treatment centre jointly with its Norwegian partner. By this time, the latter had constructed a solid expertise in the field of IPV. Both members share the same structure of therapy, though there are some differences in their treatment ground model.

10 _{A report conducted in 2016 by Statistics of Sweden shows that 25% of women admitted to "being}

subjected to intimate partner violence at some point in their lives" (Statistiska Centralbyran, 2016, 85). The report points out a lack of reported crimes which demonstrates that many more cases still exists even if not reported.

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11 _{The participants of this research also provided the information of this subsection.}

Enrollment

11

As seen above, a series of actors and institutions from distinct societal levels – national and regional authorities, health professionals, scholars and activists – are involved in the treatment process for perpetrators. In the Nordic countries, a perpetrator seeks treatment voluntarily, even if convicted and arrested. Dissemination of information on the offered treatment is essential for the institution to receive more clients and, consequently, reduce IPV in society.

The Swedish branch of the institution does not focus on a particular gender when disseminating their work to future clients. Rather, their target is all people that want to seek help voluntarily for their violent behaviour(s). There is an effort from the professionals to engage with other places that work in/directly with the field of IPV. The healthcare system and social services are their closest allies. During the meetings with these organizations, the staff present their work and give training on the nature of IPV. Every second year, the Swedish team conducts PR campaigns to promote their work. The justification for providing therapeutic treatment to perpetrators for other professionals is something frequently discussed. The psychologists emphasize the need for focusing on violence since it appears as an important social theme.

Similarly, in Norway, the different offices of the institution focus on all genders and ensure that their work is visible. In order to attract people, the Norwegian agencies have different tactics. Conferences about violence are one of the mechanisms used. The staff members of the institution conduct lectures and workshops with staff members of schools and hospitals on the topic of violence within the family, the consequences of violence and key signs for identifying it. Reaching out to nurses to dialogue about IPV is another form of spreading the word. Advertising the institution on the internet, newspapers and cinemas are used to attract people and inform the population about the institution.

The child protection services and family therapy offices refer potential clients to the institution. Their cooperation goes beyond this since the Norwegian staff counts on these organizations’ efficiency when necessary. Another way to book a therapy session is by calling the institution directly or calling the Red Cross help line and/or the Crisis Centres.

There are various reasons for perpetrators to seek treatment. For some of them, it is their partner that demands the search for treatment and threatens to break up with them if they do not take such action. For others, the concern about their actions and identity as a violent person is the biggest motivation. Some clients want reassurance that they will not begin a new relationship with violent mindset. The motivation for improving their identity as fathers is also important for some clients.

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12 _{The participants of this research also provided the information of this subsection.}

In most cases, the clients search for treatment happens immediately after a crisis begins. This period is when they are most emotionally vulnerable and in search of options that before were seen as impossible. For the psychologists, the ideal situation would be to receive a call in the first incidence of violence, rather than when violence has already happened. This preference is because, in most cases, when violence occurs, the relationship is irreconcilably destroyed and it is very difficult to repair it.

Apart from local strategies, the institution ensures an open dialogue at the national level to continue its work. It is important to make the institution reachable also to those that provide funding for treatment. There is an effort from the institution's director to meet with politicians or governmental agencies. The results of such dialogue are visible since the current opening of new offices indicates the possibility of treatment to different regions.

Therapy

The length of treatment varies between clients, but it is approximately 15 to 30 sessions in the Swedish office, and ten to 15 sessions in the Norwegian offices, for individual therapies. Some psychologists ask their clients to attend therapy for a minimum of half a year. This solicitation is because they want their clients to appreciate the process of patience, by highlighting that the act of change takes time and effort. For the group therapies, the typical length is 24 sessions. This longer length is because professionals focus on having an impact on the clients that are not motivated to stay, in an attempt to reduce the number of drop-outs. The sessions are conducted weekly.

The Swedish branch of the institution provides an online treatment for clients, with the aim of reaching a different population that do not want to attend individual/group face-to-face therapy. At the same time, the Norwegian branch of the institution initiated a new project with male refugees to inform them about laws and rights in Norway, different types of violence and the consequences for those exposed to the violence.

Institutional Training

12

The professionals employed by the institution mentioned above chose to work precisely with perpetrators of IPV in the therapeutic setting. It is rare to see recently graduated psychologists with experience in clinical work with this group of clients. Bachelor and Master degrees tend not to teach their students about violence in general and much less about the therapeutic process involving perpetrators. Therefore, it is necessary for the institution to provide adequate training to the new therapist on the institution model and its theoretical frameworks. The institution acknowledges their psychologists as unique individuals immersed

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in different surroundings, consequently, relating to their work differently. However, even with such understanding, the institution believes that its training provides an equal and necessary basis to all staff members.

Reviewing previous literature about violence and the structure of the institution are initial steps taken by the psychologists to familiarize with the contents of their job. The institution provides an initial course at entry level where the professionals learn about the institution’s history and its approach towards IPV.

The institution ground model centres on four pillars: the history of violence; responsibility; consequences for the clients and their intimate partners; and end of violence. In Sweden, because of work preferences, professionals have modified the ground model by adding more guidelines.

The institution perceives IPV as a both structural and individual issue. For the professionals, violence is one of the symptoms of a romantic relationship facing challenges. Also, it represents the power of men over women manifested in the societal scenario. Gender inequality and rigid masculine/feminine norms merge with the individual psychological understanding of self, other and the environment.

What is in the clients’ background that allows psychologists to comprehend the violent act? What are clients’ notions of masculinity and femininity that contribute to an unequal relation with their intimate partners? What are the social and political forces contributing to the appearance of the violence? These are a few questions that guide the psychologists to observe the gender power approach illustrated in society.

For one year, therapists receive supervision from more experienced psychologists. During this period of training, professionals have the opportunity to design the type of treatment they are going to provide. The institution encourages them to develop a therapeutic model that combines the principles of the institution's ground model with the psychologists’ theoretical preferences and the particular client in therapy. This combination ensures that the needs of each client are going to be met since it rejects one fit-all type of treatment.

Psychologists

13

This thesis investigates the discourses of six psychologists working at the studied institution. Two of them, Fabian14 _{and Erik, work in the Swedish office. Bianca, Luca, Paul and}

John work in different Norwegian offices across the country. These professionals started working at the institution in distinct periods. Two of them have been working for one year, one

13 _{The participants in this study also provided the information for this subsection.}

14 _{The names of the participants – Erik, Fabian, Luca, Bianca, Paul and John – were randomly chosen.}

Due to the ethical consideration regarding anonymity, I had to choose names that did not resemble at all the original ones.

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of them for about ten years and three of them since the institution respective foundations (Norway – 1987; Sweden – 2010).

Fabian decided to apply for his current position – psychologist conducting therapy with perpetrators at the Swedish branch of the institution – as soon as he saw the job announcement. At the beginning of his professional career, Fabian worked with clients who had psychosomatic complaints, such as headaches and body pain. Many of his clients were experiencing violence in their relationship, which helped Fabian to become familiar with the field. After this job, Fabian worked at a treatment centre for people with addictions, such as alcohol and substance abuse. Violence was also a present theme in this group of clients.

Fabian’s colleague, Erik, took a significant change in his career when accepting his current job as a psychotherapist for perpetrators in the Swedish branch of the institution. After 25 years working with teenagers and adults with drug addiction in a psychiatric hospital, the licensed psychotherapist was motivated to look for something new. The daily commute to a different city to conduct his work became an obstacle. Besides, the former nurse was already interested in treating clients with a particular issue, which lead him to the field of IPV. It was not that he was entirely unfamiliar with the area since some of the children he met at the psychiatric clinic were suffering from violence in the family. However, violence was experienced from a different perspective.

Similarly, John also spent most of his professional career working at drug abuse centres, before accepting his current job as a psychologist conducting therapy to perpetrators in one of the Norwegian offices. He explains that the interest in working with this phenomenon and, consequently, at the institution, was more of a coincidence of life events than a strong desire. Since the start, John has been very pleased with working with the institution and affirms that nothing else can satisfy him. His involvement with IPV not only appears by being a therapist for perpetrators but also to survivors. His speech demonstrates that he is very proud of being able to see all sides of the family in such a complex phenomenon and assist the men, women and small children involved in it. Apart from his work as a therapist, John researches IPV in the family context.

Paul also does research apart from being a therapist for perpetrators in one of the Norwegian offices. Paul started to work at the institution after finishing his education in Psychology. The psychologist shared his fascination for the influential aspect of Norwegian criminology on his work and, broadly, in the field. His research addresses important issues that contribute to the alliance between therapist and client in this precise therapeutic setting. Paul also conducts training groups and lectures for newcomers when entering the organization.

Paul’s colleague, Luca, had six years of experience in a psychiatric intensive care unit before starting to provide therapeutic treatment to perpetrators in one of the Norwegian offices. Luca shared his discontent with working as a regular psychologist at the hospital unit and the

Therapeutic Alliance between Psychologists and Perpetrators of Intimate Partner Violence: A Feminist Ethics of Care Interpretation